HomeMy WebLinkAbout10199912 - Permitq
Unit Bldg: Address Range Suile Range:
Zoning: R1Assessor's Parcel.001-091-03 Lot. 184 Block: NA Iracl:1724 Historic No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O1999{2
Pin #: 3E662
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwolling
Reroof
REROOF
SFD WATT GARAGE
Occupancy:
constr Type
Code:
Flood Zone:
# of Stories:
R.3, U
VB
cBc 2016
x4602320144J
1st FL Area.
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd
Valuation:$3,468.00
Oescription of Work: Tear off existing roof material and install new comp shingle roof material.
Planning Conditions: Repair damaged fascia, eaves, rafters as needed
Owner:
Address:
Phone:
Tenant
Owner-Builder
Address
Xevin W. Harris
2136 N. Alona St.
Santa Ana, CA 927045507
(7'r4) 307-5082
Architect /
Designerl
Address:
Phone:
License #
Phone:
License #
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Soto, Ricardo
Chavez,Oave
?a/
Dale: 0412612019
Date:
Oate 0412412019
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07116002 51601 Permit Fee
07776002 57672 Bldg. Stds. Revolving
07776002 57600 Gene.al Plan Update
07776002 51601 lssuance
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
lnspector MID#: 2019-15'1060
Fee Total:
Paid to Date:
Balance Due
$398.62
$0.00
3398.62
No
No
No
No
U Account#Total
01 1 '16002 51600
01 1 '16002 51601
01116002 51612
$22.08
$375.54
$1.00
Project Address: 2136 N Alona St
Contractor:
Addressl
Engineer:0ff ice: CTYH
nn Updote
5l6rr:r00[r-
5 160 1 orrtt -
Revol v r trs
It,5l2tttllr-
pt+ ! 112599431
onsocL too
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
GEneroI P
0l t l60tl2-
t[r ild ine
0l I l6Lru2-
Blde Stds
rll t l6Lr02-
ICL (:heck
$320.50
$1 .00
$22.08
$ss.04
Every pemil issued shall become invahd unless the wod< on the sito authonzed by
such pomit iscommenced within 3@ days afrer its issuance.ot il the wod authorizod
on the site by such pemit is suspended ot abandoned for a peiod of 360 days aftet
the tine the wo* is conmenced .
BUILDING. INSPECTOR RECOHD
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Set Backs
Forms/Steeli Holdowns
Erection Pads
SLAB Floor
Subf loorVenUl nsulation
Rool Sheathing q-2%/7 //c.,"
Shear Wall I
Framing
lnsulationi Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
H andicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL T4 t7 u< z)
Certilicate ot Occupancy
Notes, Remarks, Etcb)* LJ*-
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MAYOR
MiguelA. Pulido
MAYOR PRO TEM
Michele lvlartinez
COUNCILI\,4EMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDING AGENCY
20 Civic Center Plaza
P.O. Box 1988 . Santa Ana, California 92702
www.santa-ana.org / pba
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application lor a building permit has been submitted in your name listing yoursell as the builder of the property
improvements specified at TrtEo
WeareproVidingyouwithantomakeyoUaWareof
your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder.
We will not issue a building permit until you have read, initialed your understanding ol each provision, signed, and returned
this form to us at our oflicial address indicated. An agent of the owner cannot execute this notice unless you, the property
owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON
DIBECTIONS: Read and initial each statement below to signity you understand or verify this intormation.
^/.iL-lnfg\l . t understand a trequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel'
duilding permit thal erroneously implies that the property owner is providing his or her own labor and material personally. l,
as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed
person and his or her employees while working on my property. Nily homeowner's lnsurance may not provide coverage for
those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to
workers on my property.
)Mr. tunderstand building permits are not required to be signed by property owners unless they are responsible for
th'e construction and are not hiring a licensed Conlractor to assume this responsibility.
M I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
ffi&t mysell from potenlial linancial risk by hiring a licensed Coniractor and having the permlt filed in his or her name
lnstead ol m y own
I understand Contractors are required by law to be licensed and bonded in California and to list their license
ers on permits and contracts
5. I understand if lem ploy or otherwise engage any persons, other than California licensed Contractors, and the
o value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employer" under stale and federal law.
)M. I understand if I am considered an "employer" under state and Federal law, I must register with the state and
i6&JEl gorernment, withhold payroll taxes, provide workers' compensation disability insurance: and contribute to
unemployment compensation ol each "employee." I also understand my failure to abide by these laws may subject me to
serious linancial risk.
-W, . , understand under Calilornia Conlractors' State License Law, an Owner-Builder who builds single{amily
rEsidential structures cannol legally build them with the intent to offer them lor sale, unless a//work is performed by
SANTA ANA CITY COUNCIL
CIry N{ANAGER
Raul Godinez ll
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
moulido@sanIa-ana.oro
Mayor Pro Tem, Ward 2
mimanrrez@santa.ana.oro vsarmie.to@saora ana oro isdsio@$da:a!!.qg
P David Aenavides
dbenav des@santa-ana.oro ivilaeoas@santa-ana.oro
SalTirajero
sllnaiero@sanb-ana.o..
licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
performed under contract with a licensed general building Contractor.
lt
l&::X. t understand as an OwnerBuilder if I sell the property for which this permit is issued, I may be held llable for any
finidncial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
tltLtW'9. I understand l may obtain more information regarding my obligations as an "employer" f rom the lnternal Revenue
66rVice, the United States Small Business Administration, the Calilornia Department of Benelit Payments, and the
California Division ol lndustrial Accidents. I also understand I may contact the California Contractors' State License Board
(CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov lor more inlormation about licensed contractors.
Wa
address:
I am aware ol and consent to an Owner-Builder building permit applied for in my name, and understand that I am
legally a nd f inan ally r ons tor propos ed construction ctiv at the fol rng ob0
)fu,,,
all applicab
)&o,^
ihforlnation
agree that, as the party legally and financially responsible for this proposed construction activity, lwill abide by
le laws and requirements that govern Owner-Bullders as well as employers.
gree lo notily the issuer of this lorm immediately of any additions, deletions, or changes to any of the
I have provided on this form.
Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not
have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain
as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important lor
you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your
property, you may be held liable for damages. ll you obtain a permit as Owner-Builder and wish to hire Contactors, you will
be responsible Ior verifying whether or not those Contractors are properly licensed and the status of lheir workers'
compensation insurance coverage.
Betore a building permit can be issued, this form musl be completed and signed by the property owner and
returned to the agency responsibfe lor issuing the permit. Arore.' A copv of the Dropertv owner's drivet's license.
form notarization, or other veritication acceptable to the aoencv is reouired to be presented when the permit is
to the owner nature.
Signature of Property
Print name of Owner
Owner Date //)a
0 5
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which lunderstand is my personal responsibil,ty. I hereby authorize the
lollowing person(s) to act as my agent(s) to apply for. sign, and file the documents necessary to obtain an Owner'Builder Permil for my
project.
Scope ol Construction Project (or Description of Work)
Projecl Location or Address
Name oJ Authorized Agent
Address of Authorized Agent
Phone Number of Authorized Agent
I declare under penalty ol perlury that I am the property owner for the address listed above and I personally iilled out the above
information and certify its accuracy.
Property Owner's Signature Date
Print Name ol Owner
Note: A copy of the owner's driver's license,lorm notarization, or other verification acceptable to the agency is required to
be presented when the permit is issued to verily lhe property owner's signature.
SANTA ANA CITY COUNCIL
mouldoaAsanla-ana oro
lrayor Pro Tefi. Ward 2
mrmanine2@sarla ana oro
Vrcenre Sarmienlo
vsarmienlo@sanra anaoro isolorio@santa'ana.oro
P. David Beravides
db€navrdes@sanra-ana oro ivilleoas@santa'ana oro $ naiero@$nta-ana oro